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Old 11.02.2019, 08:18
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Psychiatrist practice in Switzerland

Hi all!

I am new here and I could really use some advice if you have experience in this field. I am currently in Bern and considering staying for few years. I was wondering what are psychiatrist practice here? After I chose my GP, he will send me to psychiatrist or I can chose one by myself? As I already have prescribed therapy, should I expect to continue with that or something similar, or I will have to go from the beginning of whole process, trying new methods and meds?

Any information will be greatly appreciated because this matter could be stay or leave for me. And I'd like to stay.

AH, and yes, I am aware that I just presented myself in first post on this forum as a real nutcase.

Thanks in advance, guys!
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Old 11.02.2019, 08:19
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Re: Psychiatrist practice in Switzerland

What type of health insurance do you have?
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Old 11.02.2019, 08:37
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Re: Psychiatrist practice in Switzerland

As a matter of fact, I have none right now. I am still in tourist/visiting mode (took unpaid leave). But there is great possibility that my husband will get contract prolonged for few more years so this could be reason to stay or leave. If that helps, I can go up to 500 CHF per month for health insurance. I am taking in advices about health insurance too, considering fact that I really have condition (general anxiety disorder with occasional panic attacks) that requires meds and psychotherapy.
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Old 11.02.2019, 09:05
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Re: Psychiatrist practice in Switzerland

Do you really need a phychiatrist ?



Surely your Doctor would be able to advise you properly
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Old 11.02.2019, 09:18
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Yes, I am pretty sure that I need one. My therapy includes antidepressants and anxiolytics. I am not sure that I can get them from my GP doctor. And also, I'd like to continue psychotherapy. I know that part can be done with psychotherapist but not sure about meds part. In general, I just wanted to hear maybe some experiences of people with same problem... How it goes here and so on... If it is uncomfortable to speak in public about that, I don't mind correspondence via PM.

Don't get me wrong - I wouldn't mind being drug-free. But I have this issue since half of my life. I manage to finish my Master Degree and work full time, have kid and so on... I am on meds from last years because my condition was getting worse so that was really last resort for me.

Last edited by 3Wishes; 11.02.2019 at 21:55. Reason: merging consecutive replies
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Old 11.02.2019, 09:23
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Re: Psychiatrist practice in Switzerland

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As a matter of fact, I have none right now.
I asked, since the procedure you need to follow will depend on the health plan you have here. Some plans which are slightly less expensive, require you to go through your doctor first before consulting a specialist.
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Old 11.02.2019, 10:01
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Re: Psychiatrist practice in Switzerland

That really doesn't matter to me if it is only for the first time. I hope that I don't have to go every time to my doctor before I visit psychiatrist or need my monthly med supplies. or do I? I am really not familiar with details of health practice here. I read a lot of stuff but most of them are pretty general. I just hope psychiatrist here are not hard to give you needed meds (in justified cases like mine).
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Old 11.02.2019, 10:02
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Re: Psychiatrist practice in Switzerland

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That really doesn't matter to me if it is only for the first time. I hope that I don't have to go every time to my doctor before I visit psychiatrist or need my monthly med supplies. or do I?.
No.
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Old 11.02.2019, 10:11
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Re: Psychiatrist practice in Switzerland

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That really doesn't matter to me if it is only for the first time. I hope that I don't have to go every time to my doctor before I visit psychiatrist or need my monthly med supplies. or do I? I am really not familiar with details of health practice here. I read a lot of stuff but most of them are pretty general. I just hope psychiatrist here are not hard to give you needed meds (in justified cases like mine).
Your general doctor will refer you to the psychiatrist and write a ‘Bon de delegation’ for the health insurance ( no idea what that is in German) which proves to them that s/he actually referred you. If the GP is sensible they will make it for the whole year and not just one visit.

Bear is mind that a psychiatrist is covered by the basic insurance but a psychologist is not unless the treatment is followed in conjunction with a psychiatrist.
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Old 11.02.2019, 10:12
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Re: Psychiatrist practice in Switzerland

Great. Thank you on info. i hope someone with similiar problem will be able to give me more information about this issue.
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Old 11.02.2019, 10:28
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Re: Psychiatrist practice in Switzerland

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If the GP is sensible they will make it for the whole year and not just one visit.
Once should be sufficient. Though I have heard of health insurance saying that it 'expires'. To me though this just ridiculous and creates more costs, making you go back to the doctor so they can 'put it in the system' again.
Another situation is where you have ongoing treatment at the end of the year and change insurer. The new one can refuse to recognise it as 'ongoing treatment', this also creates an unnecessary extra appointment.
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Old 11.02.2019, 10:39
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Re: Psychiatrist practice in Switzerland

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Once should be sufficient. Though I have heard of health insurance saying that it 'expires'. To me though this just ridiculous and creates more costs, making you go back to the doctor so they can 'put it in the system' again.
The ‘cheaper’ insurers often request it for every visit unless the referring doctor has made it clear that it is for the whole year. Most doctors are aware of this and word their documents appropriately.
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Old 11.02.2019, 13:41
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Re: Psychiatrist practice in Switzerland

Thank you very much on any information. It is all good to know. I don't know why I can't thank you automatically on your responses...
Anyway, is there anyone who came here with some diagnosis and was able to get same meds as those used before (for example in home country)?
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Old 11.02.2019, 13:46
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Re: Psychiatrist practice in Switzerland

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Thank you very much on any information. It is all good to know. I don't know why I can't thank you automatically on your responses...
Anyway, is there anyone who came here with some diagnosis and was able to get same meds as those used before (for example in home country)?
If the meds are licences here then there is usually no problem in getting the same ones. I have no experience of the meds you are using but for other meds there was no problem getting the same ones here as we had back in Belgium.

Once you have 10 posts you will be able to thank people for their posts.
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Old 11.02.2019, 19:50
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Re: Psychiatrist practice in Switzerland

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is there anyone who came here with some diagnosis and was able to get same meds as those used before (for example in home country)?
Which medication?
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The ‘cheaper’ insurers often request it for every visit unless the referring doctor has made it clear that it is for the whole year.
Which is ludicrous as it's just another thing that drives up costs. Once a referral is in the system, that should be it. Nobody keeps going to these appointments for fun.

Last edited by Clocker; 11.02.2019 at 20:04.
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Old 11.02.2019, 22:15
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Re: Psychiatrist practice in Switzerland

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Thank you very much on any information. It is all good to know. I don't know why I can't thank you automatically on your responses...
Anyway, is there anyone who came here with some diagnosis and was able to get same meds as those used before (for example in home country)?
When I moved here in 2007, I went to my new GP with a list of my medications from the US and he prescribed the Swiss equivalents, including my psych meds. Many of the standard psych meds - SSRI, benzodiazepines, probably anti psychotics are available here. Some stimulants, such as adderal are not.

If you have your docs wherever you come from write you a letter describing your diagnosis and treatment, and if you can speak about your medical history, that will help. You need to advocate for yourself, just a little.

I’ve seen a psychiatrist just a few times here, there should be no problem in seeing one.
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Old 11.02.2019, 22:40
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Re: Psychiatrist practice in Switzerland

I saw a psychiatrist the whole time I was living in Switzerland for anxiety and depression.

Like edot, I went to my GP with a list of meds, and they prescribed me the Swiss equivalent. I told them I needed to be followed by a psychiatrist, and they gave me the number for the outpatient clinic of the local psychiatric hospital. Incidentally, I later found out I could have contacted any psychiatrist / clinic. I eventually got an appointment with a psychiatrist, who I saw for the next 6 years. Frequency varied between once a month and once a week, depending on the severity of my symptoms. She was also a psychotherapist so she handled my therapy and my medication. I also did several courses of CBT as an outpatient in the hospital, and I also went to occupational therapy there. I also had my share of hospitalisations, but that's another story.

My psychiatrist moved to a different outpatient clinic in the area, and I followed her there. Later she moved to a private clinic, and again I followed her. When she eventually moved to a geriatric ward in Geneva, I was taken on by another psychiatrist at the clinic. All very straightforward.

I think every so often my health insurance wrote to my psychiatrist to query if I still needed treatment, and they would write a report. Everything was covered.

I had basic health insurance, with Assura, with a CHF300 deductible (the lowest). With Assura you are supposed to pay for your medication and treatment up front and claim it back, but I was able to arrange something called a 'cession de creance' which was a document allowing my pharmacy and the clinic to claim their costs directly from Assura, so that I wasn't having to pay huge bills. I had a model where I could choose which doctor and specialist I saw.

I hope that is useful. The only thing I would suggest, if you are able, is to maybe take your medication to a pharmacy and find if it is usually prescribed in Switzerland on a long term basis. I didn't have an issue when I moved to Switzerland, but on moving back to the UK I found a medication I had been routinely prescribed in Switzerland was not prescribed long-term in the UK. I had to come off it, which resulted in a bit of a round of 'find the right medication balance to replace the missing medication'. Hopefully that won't happen to you, but it might be worth checking.

All the best!
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Old 12.02.2019, 00:23
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Re: Psychiatrist practice in Switzerland

Yes a lot of expats feel depressed at some point in Switzerland !



Probably the best thing to do would be to ask around you,
among friends and acquaintances, although asking here
may get you some friendly recommendations.

I have 2 friends in Switzerland who consulted a psychiatrist or psychologist,
one is a very sweet girl who is bipolar, to me she is normal (just a bit f*-up)I have never seen
her bipolar, I just know she is a drug and alcohol user. But she's been committed (voluntarily)
several times to a hospital as it's frequent here in Switzerland. She told me there are good places
and bad places . I think all those who have gone to a psychiatrist have tried several
before finding the right one, or a good one.
Usually girls tell you about their experience (I guess guys don't talk about going to
a shrink), and I often had discussions about what they do, why and for how long (a long long time usually ) .


From what I heard and things I read, in Switzerland I think you must be aware of a couple things,

- the medical profession doesn't have the same code of conduct as in other countries
and for sure with expats it raises eyebrows, here doctors run a business.
In the case of psychiatrists, they are among the highest earners among medical professionals
(ask yourself why, I believe they get a lot of business from the state but that's not the only reason)

- in case of malpractice, you are out of luck (yes you can go to court but it goes nowhere)
there was even a case of sexual misconduct on vulnerable patients, and the shrink got away with it
(I think he didn't even get his name published so people couldn't know which doctor it was)
There were cases of people being overmedicated, treatment costing thousands per month and so on.
Horror stories !

- but first of all , in case you don't know : psychiatry in Europe and in Switzerland is different from the practice in the
US (the UK?), psychiatry in Europe is generally speaking, how to put it... backward , at least it's not the same as in the US.
But that doesn't explain why Switzerland is the place where there is the most abuses/malpractices (Western world I mean).
Switzerland has always been big on psychiatry, look it up and you'll find many "famous" pioneers of psychiatry were Swiss.
They were eugenicists and saw the emerging field of psychiatry as a way to control society,
and do away with "the low lives". This mindset is still present in today's Switzerland to some extent,
and some groups defending patients have decried the abuses of Swiss psychiatry (obviously this doesn t apply to all practices in Switzerland).
If you are an average patient with a condition that doesn't call for commitment, no worries...
I guess your shrink may push for medication you wouldn't get otherwise and you'll have to keep an
eye on the bills.

Now maybe I have really scared you, but I think there is some bad stuff people need to know, doens't mean you should expect bad things. Above all, try to get several feedbacks from people who consulted, is it a good, nice, understanding person ? That's what I would do I guess .
My feeling is you know this field attracts people for the wrong reasons, psychiatrists have a lot of power over their patients, and when you think that the culture in Switzerland is very much controlling, and often intolerant, and that they think they can never be wrong, you choose your Swiss shrink carefully ! You don't want one who will fleece you or have you committed .
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Old 12.02.2019, 17:28
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Re: Psychiatrist practice in Switzerland

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Your general doctor will refer you to the psychiatrist and write a ‘Bon de delegation’ for the health insurance ( no idea what that is in German)
Überweisungsbestätigung maybe... other insurance companies may call it something similar.
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Old 12.02.2019, 20:39
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Re: Psychiatrist practice in Switzerland

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Yes a lot of expats feel depressed at some point in Switzerland !



Probably the best thing to do would be to ask around you,
among friends and acquaintances, although asking here
may get you some friendly recommendations.

I have 2 friends in Switzerland who consulted a psychiatrist or psychologist,
one is a very sweet girl who is bipolar, to me she is normal (just a bit f*-up)I have never seen
her bipolar, I just know she is a drug and alcohol user. But she's been committed (voluntarily)
several times to a hospital as it's frequent here in Switzerland. She told me there are good places
and bad places . I think all those who have gone to a psychiatrist have tried several
before finding the right one, or a good one.
Usually girls tell you about their experience (I guess guys don't talk about going to
a shrink), and I often had discussions about what they do, why and for how long (a long long time usually ) .


From what I heard and things I read, in Switzerland I think you must be aware of a couple things,

- the medical profession doesn't have the same code of conduct as in other countries
and for sure with expats it raises eyebrows, here doctors run a business.
In the case of psychiatrists, they are among the highest earners among medical professionals
(ask yourself why, I believe they get a lot of business from the state but that's not the only reason)

- in case of malpractice, you are out of luck (yes you can go to court but it goes nowhere)
there was even a case of sexual misconduct on vulnerable patients, and the shrink got away with it
(I think he didn't even get his name published so people couldn't know which doctor it was)
There were cases of people being overmedicated, treatment costing thousands per month and so on.
Horror stories !

- but first of all , in case you don't know : psychiatry in Europe and in Switzerland is different from the practice in the
US (the UK?), psychiatry in Europe is generally speaking, how to put it... backward , at least it's not the same as in the US.
But that doesn't explain why Switzerland is the place where there is the most abuses/malpractices (Western world I mean).
Switzerland has always been big on psychiatry, look it up and you'll find many "famous" pioneers of psychiatry were Swiss.
They were eugenicists and saw the emerging field of psychiatry as a way to control society,
and do away with "the low lives". This mindset is still present in today's Switzerland to some extent,
and some groups defending patients have decried the abuses of Swiss psychiatry (obviously this doesn t apply to all practices in Switzerland).
If you are an average patient with a condition that doesn't call for commitment, no worries...
I guess your shrink may push for medication you wouldn't get otherwise and you'll have to keep an
eye on the bills.

Now maybe I have really scared you, but I think there is some bad stuff people need to know, doens't mean you should expect bad things. Above all, try to get several feedbacks from people who consulted, is it a good, nice, understanding person ? That's what I would do I guess .
My feeling is you know this field attracts people for the wrong reasons, psychiatrists have a lot of power over their patients, and when you think that the culture in Switzerland is very much controlling, and often intolerant, and that they think they can never be wrong, you choose your Swiss shrink carefully ! You don't want one who will fleece you or have you committed .
Please don’t listen to this advice! Here in Switzerland, you will find very kind, understanding and professional doctors in mental healthcare. I would personally try and choose someone based upon personal recommendation if you can - it can take time to find the right doctor and that’s perfectly fine. All the best!
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